Toward Automating the Selection of Articles Reporting EQ-5D Data for Systematic Literature Reviews Using Large Language Models: Algorithm Development and Evaluation Study.

BACKGROUND: Systematic literature reviews (SLRs) are essential for evidence synthesis in health research but remain labor-intensive, especially at the screening stage. Manual review of titles and abstracts requires substantial human effort, while existing automation tools still have limited adoption in health technology assessment. The EQ-5D questionnaire, a widely used patient-reported outcome measure for health-related quality of life, provides data that frequently underpin reimbursement and policy decisions. OBJECTIVE: This pilot study evaluated whether recent large language models (LLMs) can support the identification of publications reporting EQ-5D data in PubMed records, using only publicly available metadata (title, abstract, and keywords). METHODS: A total of 200 publications retrieved through the EuroQol PubMed filter were manually labeled by experts as reporting or not reporting EQ-5D data. The dataset was split into stratified training, validation, and test subsets. Several machine learning approaches were compared, including a Naïve Bayes baseline using bag-of-words features, a decision-tree model based on full-text keyword occurrence, and transformer-based LLMs (Bidirectional Encoder Representations from Transformers [BERT], Biomedical BERT [BioBERT], Scientific BERT [SciBERT], and Biomedical Language Understanding Evaluation BERT [BlueBERT]). Both classifier-only and fine-tuned configurations were tested across multiple learning rates. Model performance was assessed using accuracy, precision, recall, and F1-score. RESULTS: Baseline approaches achieved near-random test performance (accuracy around 0.53). Classifier-only LLMs modestly improved results (accuracy up to 0.64 with SciBERT). Fine-tuned models substantially outperformed these baselines, with BERT and BioBERT achieving the best performance (accuracy=0.70; F1-score=0.68). In screening-oriented evaluation, this configuration achieved 90.0% sensitivity, 40.0% specificity, and 6 false negatives on the held-out test set. The models reproduced human screening tendencies despite the small dataset size, demonstrating the technical feasibility of LLM-assisted article selection. CONCLUSIONS: This study provides the first demonstration of LLM-assisted identification of EQ-5D data in biomedical literature. The findings support technical feasibility but do not establish a reliable stand-alone automated screening tool. Although limited by dataset size, the proposed workflow is reproducible and adaptable to other patient-reported outcome measures. Because validation was based on a single small train-validation-test split, the results should be interpreted as preliminary; future work will scale data collection, include statistical testing, and explore semisupervised learning to further reduce manual screening workload.